Background : Research shows that one third of all persons in South Africa have been exposed to one or more types of aggression. It has been observed that learners frequently experience aggression from teachers in the secondary school environment, which has a negative effect on their experience of general wellbeing and mental health.

Objectives : The objectives set for this research were to explore and describe learners' experiences regarding teachers' aggression toward them and to formulate guidelines for learners and teachers to facilitate their mental health.
Method : The population consisted of school learners at a secondary school. Inclusion criteria for sampling were that participants should be grade 11 and 12 learners, between 16 and 18 years of age and should have experienced aggression from teachers in the school. A purposive sample was taken of learners who complied with the inclusion criteria. Data were collected by means of four in-depth phenomenological interviews, 88 naïve sketches, observation and field notes. One central question was posed to the secondary school learners: 'What are your experiences of teacher aggression toward you in your schooling environment?' Open coding was used for data analysis. Measures to ensure trustworthiness were applied to ensure the rigour of the research. Ethical principles were adhered to throughout the research process.
Results : The secondary school learners were belittled, as well as emotionally and verbally abused. They also experienced fear and anger. Guidelines were derived from these findings for learners and teachers.
Conclusion : This research found that learners experience aggression in their school environment and need support to facilitate their mental health.

Background : Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV and AIDS) remain a serious threat to population health and economic well-being of individuals in conflict societies. Sub-Saharan Africa (SSA) is overwhelmingly affected by HIV and is the region with the highest number of armed conflicts worldwide.

Aim : The research aimed at exploring and describing the perceptions of the refugees at Humulani Village in Ba-Phalaborwa municipality, Limpopo province, about HIV and AIDS.
Objectives : The objectives included determining the gender perceptions about HIV and AIDS and also providing recommendations for ways to increase the refugees understanding of this disease.
Methods : The approach used for the research was quantitative. The target population of the study was all the refugees at Humulani Village. The sample comprised both men (n = 78) and women (n = 122) who participated by completing questionnaires. The sample of the refugees consisted of different ethnic groups from Mozambique, Nigeria, Ghana and Zimbabwe. The questionnaire consisted of two sections, section A contained the biographic data and section B interrogated the refugees' knowledge of HIV.
Results : The findings of the study revealed that the participants had low levels of knowledge regarding HIV which could be attributed to their believing the myths about HIV and AIDS.
Conclusion : The HIV-infected refugee population in Limpopo may continue to grow unless the unique needs of the refugees, such as strengthening the reproductive health services, maternal and child care and family planning, improving the educational and socio-economic status, are not addressed.

Background: The aim of the present study was to identify the factors that influence the global migration of South African anatomical pathologists working in the province of KwaZulu- Natal.

Objective: The present study answered the question 'what factors influence Kwazulu-Natal-based histopathologists to emigrate out of South Africa?', thus providing insight into an under-researched medical specialisation.
Methods: A qualitative approach and purposive sampling were used. Data included 11 in-depth interviews with histopathologists working in KwaZulu-Natal (KZN), and one interview with a former KZN-based histopathologist now working in the United States. The interviews were recorded and transcribed. The data were coded for patterns, and these patterns generated themes. The processes of coding and thematic generation were iterative.
Results: Six themes were discovered from the data. Of these, five themes suggested reasons for the potential emigration of histopathologists. These included: lack of recognition by clinical doctors, lack of career-pathing opportunities, the deterrent of compulsory service in the public sector upon qualifying, socio-economic and political instability in South Africa, and endemic levels of crime. A sixth theme revealed that remuneration was not a deciding factor as to whether histopathologists choose to emigrate.
Conclusions: Remuneration was not revealed to be a reason for emigration, as these specialists' salaries are commensurate with global salaries. The findings, whilst not generalisable, suggest that more work needs to be done on the human relations aspects of retention for these medical specialists. This has implications for human resources for health policy.

Background: A paucity of research exists that has examined temporary placements of foreign health professionals in South Africa (SA) as a possible strategy for addressing health worker shortages. The Out of Programme Experience (OOPE) initiative, run by the London GP Deanery, aims to provide a sustainable inflow of British, trainee GP doctors into rural public health facilities in SA.

Objectives: The present study explored the experiences of these British doctors working in rural hospitals in SA as part of their OOPE. The reasons and motivations underlying their decision to come to SA were also examined.
Methods: In-depth interviews were conducted with fifteen British doctors who were currently working, or had worked in the past, as part of OOPE in rural health facilities in SA. Interviews were transcribed and analysed using thematic analysis.
Results: The first theme that surfaced from the interviews was that the most common reasons underlying these doctors' motivations for coming to SA related to: the type of diseases and advanced pathologies that they would encounter; the challenge and opportunity for professional growth; and the difference in work environment that would confer on them greater responsibility and autonomy, compared to working in similar positions in the British National Health Service. The second theme, central to the participants' narratives, was the accelerated period of learning that they experienced whilst in SA. Exposure to new and unfamiliar medical cases, a greater level of autonomy and decision-making authority, and resource shortages forced greater reliance on their clinical skills and judgment, which contributed to their professional development.
Conclusion: The doctors' believed the OOPE enhanced their clinical skills and competencies. The findings provide some evidence that attests to the OOPE's potential to benefit both host facilities and the participating foreign doctors. The findings of the study have practical implications for the further development of programmes to fill vacant posts for health workers in rural South African hospitals.

Background: Malawi provides cervical cancer screening services free of charge at some public health facilities. Few women make use of these cancer screening services in Malawi and many women continue to be diagnosed with cervical cancer only during the late inoperable stages of the condition.

Objectives: The purpose of this study was to discover whether the perceived susceptibility to cervical cancer, amongst Malawian women aged 42 and older, influenced their intentions to utilise the available free cervical cancer screening services.
Method: A quantitative, cross-sectional descriptive study design was adopted. Structured interviews were conducted with 381 women who visited 3 health centres in the Blantyre District of Malawi.
Results: A statistically-significant association existed between women's intentions to be screened for cervical cancer and their knowledge about cervical cancer (X2 = 8.9; df = 1; p = 0.003) and with having heard about HPV infection (X2 = 4.2; df = 1; p = 0.041) at the 5% significance level. Cervical cancer screening services are provided free of charge in government health institutions in Malawi. Nevertheless, low perceived susceptibility to cervical cancer amongst women, aged 42 and older, might contribute to limited utilisation of cervical screening services, explaining why 80% of cervical cancer patients in Malawi were diagnosed during the late inoperable stages.
Conclusion: Malawian women lacked awareness regarding their susceptibility to cervical cancer and required information about the available cervical cancer screening services. Malawi's women, aged 42 and older, must be informed about the advantages of cervical cancer screening and about the importance of effective treatment if an early diagnosis has been made. Women aged 42 and older rarely attend antenatal, post-natal, well baby or family-planning clinics, where health education about cervical cancer screening is often provided. Consequently, these women aged 42 and older should be informed about cervical screening tests when they utilise any health services.

Background : KwaZulu-Natal province began implementation of voluntary medical male circumcision (VMMC) as an integral part of its HIV infection prevention strategy that includes other programmes such as HIV counselling and testing (HCT), screening and treatment of sexually transmitted infections and tuberculosis, and other sexual and reproductive health services. This followed randomised controlled trials that showed up to 60% HIV infection risk reduction amongst circumcised men. Implementation of the strategy occurred despite absence of knowledge of operational barriers and its acceptability to health care workers (HCWs).

Objectives : The study aimed to explore HCWs' perspectives of and barriers to strategy implementation at public sector health facilities to inform implementation policy.
Method : A purposive quota sampling method was used to select HCWs for focus group discussions at three study sites. Participants were asked open-ended questions using an interview schedule based on a literature review to explore acceptability of and perceptions regarding provision of the strategy. Thematic analysis was conducted.
Results : Acceptability of the strategy was high amongst the participants; however, there was limited knowledge of some key concepts of the strategy, personnel role confusion, missed opportunities for client recruitment, and infrastructural constraints. Negative perceptions included beliefs that VMMC would discourage condom use and cause stigma associated with non-circumcision of HIV-positive males, with perceptions of sexual behavioural disinhibition in circumcised men.
Conclusion : There is a need to engage further with stakeholders if implementation of VMMC is to be successful. More training and support needs to be provided to HCWs at public sector facilities.

Background : Chronic diseases of lifestyle are detrimentally affecting South Africans. National Health Insurance, which is intended to improve care, requires capacity building for nurses at primary care clinics to ensure appropriate service provision.

Objective : This study's objective was to evaluate the impact of the 'Primary Care 101' chronic disease management guideline and training on nurses' knowledge of chronic diseases management.
Method : A population-based, unblinded, stratified cluster randomised controlled trial with intervention (n = 20) and control clinics (n = 10) in three South African districts was conducted over six months in 2012. Nurses in the clinics participated in surveying knowledge on management of tuberculosis, human immunodeficiency virus infection, mental health, epilepsy, diabetes, hypertension and asthma and chronic obstructive pulmonary disease (COPD). All nurses were surveyed at baseline and six months later. Intervention clinic nurses were also surveyed immediately after training and three months post-training. Data were analysed using SPSS version 19 (SPSS Inc., Chicago, IL).Total mean knowledge percentage scores were calculated for each chronic disease. Mean knowledge percentage score changes between baseline and six months amongst all nurses and between intervention and control clinic nurses were compared using the paired samples t-test and independent samples t-test respectively.
Results : There were significant improvements in nurses' knowledge of hypertension and diabetes management over six months. Knowledge about asthma and COPD management decreased in all districts and nurse categories.
Conclusion : The improvements in nurses' knowledge can ensure improved patient management, but attention to asthma and COPD management is required.

Background : Interventions have been developed and implemented to reduce the stigma attached to mental illness. However, mental healthcare users are still stigmatised.

Objective : The objective of this study was to critically synthesise the best available evidence regarding interventions to reduce stigma attached to mental illness.
Method : An exploratory and descriptive research design was followed to identify primary studies; systematic review identified primary studies answering this research question: What best evidence is available regarding interventions to reduce the stigma attached to mental illness? A search was done on selected electronic databases. Seventeen studies (n = 17) were identified as providing evidence that answered the research question. The following instruments were used: Critical Appraisal Skills Programme, John Hopkins Nursing Evidence-Based Practice research evidence appraisal tool and the Academy of Nutrition and Dietetics Evidence Analysis Manual. The study was submitted to the Post-graduate Education and Research Committee of the School of Nursing Science at Potchefstroom Campus of North-West University for approval.
Results : Results indicated some interventions that reduce the stigma attached to mental illness, such as web-based approaches, printed educational materials, documentary and anti-stigma films, as well as live and video performances.
Conclusions : Humanising interventions seems to have a positive effect on reducing stigma attached to mental illness. From the results and conclusions recommendations were formulated for nursing practice, nursing education and research.

Background : Non-compliance to treatment remains one of the greatest challenges in mental healthcare services, and how to improve this remains a problem.

Aim : The aim of this study was to critically synthesise the best available evidence from literature regarding interventions to promote psychiatric patients' compliance to mental health treatment. The interventions can be made available for mental health professionals to use in clinical practice.
Method : A systematic review was chosen as a design to identify primary studies that answered the following research question: What is the current evidence on interventions to promote psychiatric patients' compliance to mental health treatment? Selected electronic databases were thoroughly searched. Studies were critically appraised and identified as answering the research questions. Evidence extraction, analysis and synthesis were then conducted by means of evidence class rating and grading of strength prescribed in the American Dietetic Association's manual.
Results : The systematic review identified several interventions that can improve patients' compliance in mental health treatment, for example adherence therapy and motivational interviewing techniques during in-hospital stay.
Conclusions : Conclusions were drawn and recommendations formulated for nursing practice, education and research.

Background : Pregnancy-related health education conveys basic information regarding healthy lifestyle choices and preventive healthcare in order to promote the health of the mother and foetus. Verbal education is supplemented frequently by means of health-promotion leaflets. A pregnancy-related leaflet used in primary care clinics in Tshwane, South Africa titled: 'Are you pregnant or planning to have a baby?' was the focus of this research.

Objectives : The study had two objectives, the first of which was to explore whether the English pregnancy leaflet improved the knowledge of young female adults with regard to maintaining their health and preventing complications during pregnancy. The second objective was to explore whether the literacy level of the young adult female had an effect on the efficacy of the English pregnancy leaflet.
Method : The research design used was a pre-test post-test design. Two samples of 30 participants each, namely, a post-secondary and a tertiary sample, participated in the study. Self-report data were gathered with a questionnaire based on the leaflet. The quantitative data were analysed using descriptive statistics and a Pearson's chi-square test.
Findings : The findings indicated both samples' prior knowledge regarding health maintenance, showing that prevention of complications during pregnancy was almost nonexistent and that the pregnancy leaflet did not improve their knowledge to an extent where they would be informed and knowledgeable about their health during pregnancy.
Conclusion : An evidence base must be developed in order to support the development of behaviour changing material.

Background : The term 'menopause' is derived from the Greek words men (month) and pausis (a cessation, a pause). It is a direct description of the psychological and physical events in women where menstruation ceases to occur. It is the time in a woman's life when she has experienced her last menstrual bleed. Menopause is not a disease per se but a condition associated with hormonal changes where oestrogen diminishes to a low level, causing aging-related health problems.

Objectives : The purpose of this study was to explore perceptions of menopause and aging amongst women in rural villages of Vhembe District in Limpopo Province, South Africa.
Method : The study was qualitative and explorative, using phenomenological approach. Purposive sampling was used to select the four villages and to select the focus groups. Sample size was determined by data saturation.
Results : The study findings were that participants in the villages associated cessation of menstruation to aging rather than menopause. Once menstruation stopped, one was regarded as old.
Conclusion : The conclusions of the study were that (1) menopausal issues should be emphasised and receive priority from puberty at the girls initiation schools, high schools, churches, other community resources and health care services so that when women reach menopause, (2) they should accept and be able to effectively cope with menopause and aging. (3) Emphasis should also be placed on menopause as the aspect of human aging.